Early Diagnosis of Lymphedema after Breast Cancer Treatment: Bio-Impedance Spectroscopy

Abstract

Objective: Breast cancer-related lymphedema is an important health problem. The aim of this study is to ensure early diagnosis of patients at risk of developing lymphedema and revealing the predisposing factors. Materials and Methods:Measurements in the pre-operative period and in postoperative months 3, 6, 9 and 12 and years 2 and 3 were performed prospectively with bio-impedance spectroscopy for patients treated for breast cancer between November, 2013 and November, 2016. Demographic and clinical-pathological data of the patients were investigated to assess the factors that affect the development of lymphedema.Results: 245 measurements were obtained from the 67 patients who participated in the study.18 (26.8%) patients were diagnosed with lymphedema and 16 (89%) of these patients were clinically diagnosed with stage 0 and 2 (1%) patients with stage 1 lymphedema. The median age was 50.7 (32-77) years. Performing axillary dissection and positivity in more than 3 nodes were found to be statistically significant with a percentage of 63.3% (n=15) and 64.7% (n=11) p=0.049 and p<0.001, respectively. Conclusion:Periodic measurements with bio impedance spectroscopy can be an effective method to diagnose early stage lymphedema after breast cancer, and enable selecting the group of patients who would benefit from early treatment.

Prospective Surveillance for Breast Cancer–Related Arm Lymphedema: A Systematic Review and Meta-Analysis

“…Specific characteristics of the 24 articles (23 studies) can be seen in Table 1. The majority of studies (83%, n 5 19) were observational, including one case-control, 38 nine prospective, [32][33][34][35][36][37][39][40][41] and nine retrospective 14,[42][43][44][45][46][47][48][49][50] cohort studies. Four studies were RCTs, 25,26,30,31 of which two studies used another surveillance program as a comparator.…”

“…42,45 Sensitivity analysis indicated that inclusion of these two studies in the pooled rates did not affect the results. The first postoperative assessment was performed within or at three months postsurgery in 20 studies (95%), 14,25,26,30,31,[33][34][35][36][37][38][39][40][41][43][44][45][46][47][48][49] of which half were within the first month. 25,30,[33][34][35]38,39,41,45,48,49 Eighteen studies (86%) performed at least three follow-up measures at regular intervals during the first year after surgery.…”

“…25,30,[33][34][35]38,39,41,45,48,49 Eighteen studies (86%) performed at least three follow-up measures at regular intervals during the first year after surgery. 14,25,26,30,31,[33][34][35][37][38][39][40][41][43][44][45][47][48][49] Twelve studies (57%) evaluated prospective surveillance and early management programs lasting more than 1 year, of which 10 studies performed annual or biannual measures for the duration of the program. 14,25,26,30,32,36,38,40,45 The length of follow-up was described in 18 studies (86%) ranging from 12 months (n 5 6, 29%) 31,35,37,39,43,47 to 5 years (n 5 3, 14%), 32,36,41,…”

The Prevalence of Lower Limb and Genital Lymphedema after Prostate Cancer Treatment: A Systematic Review

“…Moreover, bilateral measurements can be biased by muscle hypertrophy or weight gain, equally affecting both limbs. The use of techniques that evaluate edema in a direct way, such a bio-impedance spectroscopy and tissue dielectric constant measurements, can assist in the diagnosis of LE, but these techniques have not been validated in the setting of lower limb or genital LE [ 38 , 39 , 40 ].…”

Development of the Breast Cancer Related Lymphedema Self-Care Scale

“…The incidence of breast cancer related lymphedema (BRCL) is reported to vary between 13.50% and 30.00% within two years of surgery, increasing to 30.20% in the fifth year, and 41.10% in the tenth year (Ribeiro Pereira et al, 2017). In Turkey, the incidence of BRCL was up to 26.80% in the first 12 months following surgery (Kamalı Polat et al, 2017).…”